Age, gender, race, socioeconomic status, and birth cohort differences on the children's depression inventory: a meta-analysis

Adolescent depression: description, causes, and interventions

Depression is one of the most prevalent of the psychiatric disorders and is common among individuals with epilepsy. Depression often begins in adolescence. The present review focuses on adolescent depression. In particular, this review first summarizes the definition, description, and classification of adolescent depression. Next, potential causes of adolescent depression are reviewed from a vulnerability-stress perspective. This part of the review focuses on the role of stressors and how stressors interact with genetic, biological, cognitive, personality, and interpersonal vulnerabilities to predict adolescent depression. Last, clinical aspects of adolescent depression are reviewed, including treatment and prevention of depression and the relation to epileptic disorders in adolescence. In sum, a substantial percentage of youth with epilepsy and seizures exhibit depression, and many are not diagnosed or treated in a timely manner. The present review shows that there are valid, empirically based assessments, treatments, and preventions for depression in adolescence that hold promise for reducing the significant burden associated with depression.

Suicidal ideation among urban nine and ten year olds

Little is known about rates and correlates of suicidal ideation among nonclinical samples of preadolescents from low-income urban backgrounds. Using the Children's Depression Inventory, we measured suicidal ideation in 131 preadolescent urban children (49% female, 90% African American/Caribbean) participating in an ongoing prospective longitudinal study of prenatal cocaine exposure and children's outcome. Suicidal ideation was reported by 14.5% of the children in this sample at 9 to 10 years of age. Children's reports of depressive symptoms, exposure to violence, and distress symptoms in response to witnessing violence were associated with suicidal ideation, but prenatal cocaine exposure, parent-rated child behavior, and caregivers' psychological distress symptoms were not. Suicidal ideation may be more prevalent among preadolescents from urban, low-income backgrounds than clinicians suspect, particularly among children exposed to violence.

A review of sex differences in peer relationship processes: potential trade-offs for the emotional and behavioral development of girls and boys

Theory and research on sex differences in adjustment focus largely on parental, societal, and biological influences. However, it also is important to consider how peers contribute to girls' and boys' development. This article provides a critical review of sex differences in several peer relationship processes, including behavioral and social-cognitive styles, stress and coping, and relationship provisions. The authors present a speculative peer-socialization model based on this review in which the implications of these sex differences for girls' and boys' emotional and behavioral development are considered. Central to this model is the idea that sex-linked relationship processes have costs and benefits for girls' and boys' adjustment. Finally, the authors present recent research testing certain model components and propose approaches for testing understudied aspects of the model.

The gender similarities hypothesis

The differences model, which argues that males and females are vastly different psychologically, dominates the popular media. Here, the author advances a very different view, the gender similarities hypothesis, which holds that males and females are similar on most, but not all, psychological variables. Results from a review of 46 meta-analyses support the gender similarities hypothesis. Gender differences can vary substantially in magnitude at different ages and depend on the context in which measurement occurs. Overinflated claims of gender differences carry substantial costs in areas such as the workplace and relationships.

A review of sex differences in peer relationship processes: potential trade-offs for the emotional and behavioral development of girls and boys

Theory and research on sex differences in adjustment focus largely on parental, societal, and biological influences. However, it also is important to consider how peers contribute to girls' and boys' development. This article provides a critical review of sex differences in several peer relationship processes, including behavioral and social-cognitive styles, stress and coping, and relationship provisions. The authors present a speculative peer-socialization model based on this review in which the implications of these sex differences for girls' and boys' emotional and behavioral development are considered. Central to this model is the idea that sex-linked relationship processes have costs and benefits for girls' and boys' adjustment. Finally, the authors present recent research testing certain model components and propose approaches for testing understudied aspects of the model.

The Children's Depression Inventory (CDI) as measure of depression in Swedish adolescents. A normative study

Self-rating scales are an economical and practical aid in the diagnostic work-up. However, normative data from the general population are needed to interpret scores. Four hundred and five adolescents selected to be fairly representative of the general population (both ethnical Swedes and born abroad) filled in a questionnaire containing the Children's Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC) and background data (including socio-economic status (SES). The CDI was reliable in terms of internal consistency (0.86) with a mean inter-item correlation of 0.18 and item-total score correlations ranging from 0.26 to 0.57. The CDI sub-scales (Negative Mood, Ineffectiveness, Anhedonia and Negative Self-esteem had good internal consistency values slightly above 0.60, except for sub-scale Interpersonal Problems with poor internal consistency (0.36). The 90th and 95th percentiles respectively were defined by scores 15 and 18 and above for boys and by scores 20 and 23 and above for girls. Common correlates of high scores were female gender, broken family but not SES, nor ethnicity. Also, some estimates of the convergent validity of the CDI were found in a Pearson correlation of 0.40 with the MASC total score and in the capacity of the CDI (predictive validity); OR = 1.1 in predicting suicidal ideation. The CDI has some, but as of yet not sufficient indications of being a valid and reliable measure of depression in adolescence and scores can be used to indicate, though not prove the absence or presence of, depression.

Changes in psychological distress in Australia over an 8-year period: evidence for worsening in young men

OBJECTIVE

To assess whether psychological distress has changed in the Australian population.

METHOD

Data were obtained from national household surveys of 1964 Australian adults in 1995 and 3507 in 2003-2004. Psychological distress was measured using the 4-NS, which asks about symptoms of depression, anxiety, irritability and nervousness in the past month. The data were analysed by gender and by age group, from 20-24 years to 70-74 years.

RESULTS

Psychological distress was found to have increased in men aged 20-29 years. This change was observed even when the same cohorts were compared. No change was found in women or in other male age groups.

CONCLUSIONS

These data show the need for routine population monitoring of mental health to determine subgroups requiring priority action.

The prevention of depressive symptoms in children and adolescents: A meta-analytic review

Research on the prevention of depressive symptoms in children and adolescents was reviewed and synthesized with meta-analysis. When all 30 studies were included, selective prevention programs were found to be more effective than universal programs immediately following intervention. Both selective and indicated prevention programs were more effective than universal programs at follow-up, even when the 2 studies with college students were excluded. Effect sizes for selective and indicated prevention programs tended to be small to moderate, both immediately postintervention and at an average follow-up of 6 months. Most effective interventions are more accurately described as treatment rather than prevention. Suggestions for future research include testing potential moderators (e.g., age, gender, anxiety, parental depression) and mechanisms, designing programs that are developmentally appropriate and gender and culturally sensitive, including longer follow-ups, and using multiple measures and methods to assess both symptoms and diagnoses.

Gender differences in temperament: A meta-analysis

The authors used meta-analytical techniques to estimate the magnitude of gender differences in mean level and variability of 35 dimensions and 3 factors of temperament in children ages 3 months to 13 years. Effortful control showed a large difference favoring girls and the dimensions within that factor (e.g., inhibitory control: d = -.41, perceptual sensitivity: d = -0.38) showed moderate gender differences favoring girls, consistent with boys' greater incidence of externalizing disorders. Surgency showed a difference favoring boys, as did some of the dimensions within that factor (e.g., activity: d = 0.33, high-intensity pleasure: d = 0.30), consistent with boys' greater involvement in active rough-and-tumble play. Negative affectivity showed negligible gender differences.

Longitudinal associations between sibling relationship quality, parental differential treatment, and children's adjustment

This study examined associations between changes in sibling relationships and changes in parental differential treatment and corresponding changes in children's adjustment. One hundred thirty-three families were assessed at 3 time points. Parents rated children's externalizing problems, and children reported on sibling relationship quality, parental differential treatment, and depressive symptoms. On average, older siblings were 10, 12, and 16 years old, and younger siblings were 8, 10, and 14 years old at Waves 1, 2, and 3, respectively. Results from hierarchical linear modeling indicated that as sibling relationships improved over time, children's depressive symptoms decreased over time. In addition, as children were less favored over their siblings over time, children's externalizing problems increased over time. Findings highlight the developmental interplay between the sibling context and children's adjustment.

Gender differences in adolescent depression: do symptoms differ for boys and girls?

BACKGROUND

Limited prior research suggests that depressed women are more likely to experience certain symptoms of depression than are depressed men. The purpose of this study was to examine whether such gender differences in depressive symptoms are present during adolescence.

METHODS

The Childhood Version of the Schedule for Affective Disorders and Schizophrenia and the Beck Depression Inventory were administered to adolescents presenting for evaluation at an outpatient clinic (n=383; ages 11.9 to 20.0).

RESULTS

Depressed girls and boys had similar symptom prevalence and severity ratings for most depressive symptoms. However, depressed girls had more guilt, body image dissatisfaction, self-blame, self-disappointment, feelings of failure, concentration problems, difficulty working, sadness/depressed mood, sleep problems, fatigue, and health worries than depressed boys on some comparisons. In contrast, depressed boys had higher clinician ratings of anhedonia, depressed morning mood, and morning fatigue.

LIMITATIONS

Longitudinal research is needed to test whether such relatively gender-specific symptoms play different roles in the onset, maintenance, or remittance of depression for boys and girls.

CONCLUSIONS

These findings indicate that, in general, the experience of depression is highly similar for adolescent girls and boys. However, some gender differences previously found among depressed adults appear to be present by adolescence, possibly suggesting somewhat distinct etiologies for depression among males and females.

Childhood temperament and family environment as predictors of internalizing and externalizing trajectories from ages 5 to 17

Childhood temperament and family environment have been shown to predict internalizing and externalizing behavior; however, less is known about how temperament and family environment interact to predict changes in problem behavior. We conducted latent growth curve modeling on a sample assessed at ages 5, 7, 10, 14, and 17 (N = 337). Externalizing behavior decreased over time for both sexes, and internalizing behavior increased over time for girls only. Two childhood variables (fear/shyness and maternal depression) predicted boys' and girls' age-17 internalizing behavior, harsh discipline uniquely predicted boys' age-17 internalizing behavior, and maternal depression and lower family income uniquely predicted increases in girls' internalizing behavior. For externalizing behavior, an array of temperament, family environment, and Temperament x Family Environment variables predicted age-17 behavior for both sexes. Sex differences were present in the prediction of externalizing slopes, with maternal depression predicting increases in boys' externalizing behavior only when impulsivity was low, and harsh discipline predicting increases in girls' externalizing behavior only when impulsivity was high or when fear/shyness was low.

The Children's Depression Inventory and classification of major depressive disorder: validity and reliability of the Danish version

The study examines the validity and reliability of the Danish version of the Children's Depression Inventory (CDI) in a child psychiatric population. Participants were 149 child psychiatric patients aged 8-13 and their parents. After diagnostic interview with the Kiddie-Schedule for Affective Disorders and Schizophrenia, the children completed the CDI. A subgroup of 44 children repeated the CDI after 2 weeks. The psychometric properties of the Danish CDI were similar to those reported for the English version. CDI is moderately correlated with other measures for depressive disorder, but the instrument is not sufficiently reliable or valid to be used as a single diagnostic or screening measure in a child psychiatric population.

Prenatal marijuana exposure: effect on child depressive symptoms at ten years of age

Studies of the consequences of prenatal marijuana use have reported effects predominantly on the behavioral and cognitive development of the children. Research on other aspects of child neurobehavioral development, such as psychiatric symptomatology, has been limited. This study examines the relations between prenatal marijuana exposure (PME) and child depressive symptoms at 10 years of age. Data are from the 10-year follow-up of 633 mother-child dyads who participated in the Maternal Health Practices and Child Development Project. Maternal prenatal and current substance use, measures of the home environment, demographic status, and psychosocial characteristics were ascertained at prenatal months four and seven, at delivery, and at age 10. At age 10, the children also completed the Children's Depression Inventory (CDI) [M. Kovacs. The Children's Depression Inventory, Multi-Health Systems, Inc., North Tonawanda, NY, (1992).], a self-report measure of current depressive symptoms. Multivariate regressions were used to test trimester-specific effects of marijuana and their associations with the CDI total score, while controlling for significant prenatal predictors and significant current covariates of childhood depression. PME in the first and third trimesters predicted significantly increased levels of depressive symptoms. This finding remained significant after controlling for all identified covariates from both the prenatal period and the current phase at age 10. These findings reflect an association with the level of depressive symptoms rather than a diagnosis of a major depressive disorder. Other significant correlates of depressive symptoms in the children included maternal education, maternal tobacco use (prenatal or current), and the child's composite IQ score. These findings are consistent with recent reports that identify specific areas of the brain and specific brain functions that are associated with PME.

Eating disorder and depressive symptoms in urban high school girls from different ethnic backgrounds

This study examined ethnic group differences in the rates of eating disorder symptoms (EDS) and depressive disorder symptoms (DDS) with respect to ethnic identity, relative body weight, and abnormal eating behaviors among adolescent girls. A district-wide sample of high school girls (N = 1445) from different ethnic backgrounds was surveyed. EDS were assessed with the Eating Attitudes Test-26, abnormal eating behaviors with the Eating Behaviors Survey, and DDS with the Short Mood and Feelings Questionnaire. Two dimensions of ethnic identity, ethnic identity achievement and other group orientation, were assessed with Multi-Group Ethnic Identity Measure. Hispanic and non-Hispanic white girls had the highest and African-American (AA) and Caribbean girls the lowest rates of EDS. Asian girls reported the highest and AA girls the lowest rates of DDS. Early dieting was associated with EDS and DDS in Caribbean, non-Hispanic white, and mixed background girls. Relative body weight was related to EDS in all ethnic groups except in non-Hispanic white and mixed background girls. The authors did not find an effect of ethnic identity achievement on psychopathology, but there was an effect of other group orientation on both EDS and DDS. Clinicians should inquire about EDS and DDS in girls of all ethnic groups. Prevention efforts to delay unsupervised dieting may protect adolescent girls from the development of EDS and DDS.

The Longitudinal Structure of the Children's Depression Inventory: Testing a Latent Trait-State Model

In a 6-wave longitudinal study, children (Grades 4-6, n = 648), adolescents (Grades 7-9, n = 1,489), and their parents completed child-adolescent or parent versions of the Children's Depression Inventory (CDI; M. Kovacs, 1981). Using structural equation modeling, the authors conducted latent trait-state analyses to distinguish between a stable trait dimension of depression (in which individual differences are stable over time) and an autoregressive dimension (in which individual differences are less stable over time). Children's CDIs reflected the autoregressive dimension more than a stable trait dimension, whereas parents' CDIs reflected a stable trait dimension more than an autoregressive dimension. Reports from adolescents and their parents reflected a stable trait dimension more than an autoregressive dimension of depressive symptoms. Results suggest that the longitudinal structure of the CDI varies considerably depending on the age of the target and the type of informant.

Psychometric characteristics of the Beck Depression Inventory-II with college students of diverse ethnicity

Introduction To evaluate the psychometric characteristics of the Beck Depression Inventory - Second Edition (BDI-II) with an ethnically diverse sample of college students. Methods The BDI-II was completed by a group of 502 college students (54% women) with an ethnic distribution of African-American (n=49, 10%), Asian-American (n=33, 7%), Hispanic (n=113, 22%), Native-American (n=10, 2%), and White (n=297, 59%). Psychometric characteristics of the inventory with the ethnically diverse group were compared to the results published in the test manual for nonclinical samples composed predominantly of European and White participants. Results Using confirmatory factor analyses, a three-factor model that identified negative attitude, performance difficulty, and somatic dimensions, provides a better fit of the data than does the two-factor model. Similar psychometric characteristics were found between the ethnically diverse student sample and the standardization sample. Based on multivariate analysis of variance, White students had higher scores on the item of agitation compared to Asian-American students and on the items of worthlessness and irritability compared to Hispanic students. Conclusion The results of the psychometric analyses suggest that the BDI-II is suitable as a screening instrument for depression in college populations of diverse ethnicity.

Adolescent-parent attachment: Bonds that support healthy development

Adolescence is characterized by significant neurological, cognitive and sociopsychological development. With the advance of adolescence, the amount of time spent with parents typically drops while time spent with peers increases considerably. Nonetheless, parents continue to play a key role in influencing their adolescent's development. Adolescent-parent attachment has profound effects on cognitive, social and emotional functioning. Secure attachment is associated with less engagement in high risk behaviours, fewer mental health problems, and enhanced social skills and coping strategies. The present article provides a brief synopsis of the changes that occur during adolescence and describes what attachment is, why it continues to be important and how it is transformed during adolescence. It summarizes major findings on the impact of attachment on adolescent adjustment and discusses strategies for supporting healthy adolescent-parent attachment.

Emotion-related abilities and depressive symptoms in Latina mothers and their children

This study examined the abilities of 40 Latina mothers and their 6- to 11-year-old children (20 girls, 20 boys) to recognize and produce emotion expressions and how these abilities differed as a function of maternal depressive symptoms. The results indicated that depressively symptomatic mothers were less accurate at recognizing basic emotions (e.g., happy, sad, etc.) and some mixed emotions (e.g., scared/ok combinations) than nonsymptomatic mothers, but there were no group differences for emotion production. In contrast, children of symptomatic mothers posed fewer recognizable sad expressions than their peers. Error pattern analyses also revealed that children of symptomatic mothers were more likely to mistakenly recognize happiness and to avoid posing sadness (across all basic emotions). Children's ability to pose emotions was related to their mothers' emotion production, and this was not moderated by maternal depressive symptoms. The discussion focuses on the possible interpersonal consequences of these biases and deficits in the emotion-related abilities of symptomatic mothers and their children and on the need to conduct research on the familial and cultural processes that might underlie these findings.

Sleepless in Chicago: tracking the effects of adolescent sleep loss during the middle school years

The influence of the sleep patterns of 2,259 students, aged 11 to 14 years, on trajectories of depressive symptoms, self-esteem, and grades was longitudinally examined using latent growth cross-domain models. Consistent with previous research, sleep decreased over time. Students who obtained less sleep in sixth grade exhibited lower initial self-esteem and grades and higher initial levels of depressive symptoms. Similarly, students who obtained less sleep over time reported heightened levels of depressive symptoms and decreased self-esteem. Sex of the student played a strong role as a predictor of hours of sleep, self-esteem, and grades. This study underscores the role of sleep in predicting adolescents' psychosocial outcomes and highlights the importance of using idiographic methodologies in the study of developmental processes.

Reliability and Validity of the Beck Depression Inventory--II With Adolescent Psychiatric Inpatients

This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess content validity. In Study 2, confirmatory factor analyses of several first-order solutions failed to provide adequate fit estimates to data for 205 boys, 203 girls, and the combined sample. Exploratory factor analyses identified new item-factor solutions. Reliability estimates were good (range =.72 to.91) for the BDI-II total and scale scores. In Study 3 (N=161 boys and 158 girls from Study 2), preliminary evidence for estimates of concurrent, convergent, and discriminant validity were established for the BDI-II.

Ethnic and sex differences in children's depressive symptoms: mediating effects of perceived and actual competence

Examined ethnic and sex differences in depressive symptoms, along with hypothesized mediators of those differences (academic achievement, peer acceptance), for a sample of African American (n = 272) and Euro-American (n = 630) children in Grades 3 to 5. Group comparisons revealed a significant Ethnicity x Sex interaction in depressive symptoms. African American boys reported more depressive symptoms than Euro-American boys, whereas African American and Euro-American girls reported comparable levels of depressive symptoms. Sex differences in depressive symptoms differed by ethnicity: Boys were more depressed than girls in the African American group whereas girls were more depressed than boys in the Euro-American group. The Ethnicity x Sex interaction was mediated by academic achievement, but not peer acceptance. These findings have implications for understanding the mechanisms underlying depressive symptoms in preadolescence and for developing interventions to prevent depression.

Religiousness and depression: evidence for a main effect and the moderating influence of stressful life events

The association between religiousness and depressive symptoms was examined with meta-analytic methods across 147 independent investigations (N = 98,975). Across all studies, the correlation between religiousness and depressive symptoms was -.096, indicating that greater religiousness is mildly associated with fewer symptoms. The results were not moderated by gender, age, or ethnicity, but the religiousness-depression association was stronger in studies involving people who were undergoing stress due to recent life events. The results were also moderated by the type of measure of religiousness used in the study, with extrinsic religious orientation and negative religious coping (e.g., avoiding difficulties through religious activities, blaming God for difficulties) associated with higher levels of depressive symptoms, the opposite direction of the overall findings.

Socioeconomic status and child development

Socioeconomic status (SES) is one of the most widely studied constructs in the social sciences. Several ways of measuring SES have been proposed, but most include some quantification of family income, parental education, and occupational status. Research shows that SES is associated with a wide array of health, cognitive, and socioemotional outcomes in children, with effects beginning prior to birth and continuing into adulthood. A variety of mechanisms linking SES to child well-being have been proposed, with most involving differences in access to material and social resources or reactions to stress-inducing conditions by both the children themselves and their parents. For children, SES impacts well-being at multiple levels, including both family and neighborhood. Its effects are moderated by children's own characteristics, family characteristics, and external support systems.